An example of a simple requisition form with the essential elements is shown below: A properly labeled sample is essential so that the results of the test match the patient. 7. Label collection tubes after identification of the patient. Select a vein other than the one with the IV. Change gloves after each patient or when contaminated. Place a pillow under the patient's arm if additional support is needed. The median cubital creates less bruising and pain than other draw sites. When working with patients who have undergone a mastectomy, draw from the arm on the opposite side of the mastectomy to avoid edematous tissue. It is not uncommon for adults and children to feel some fear when having blood drawn, which is why any discussion of venipuncture should at least bring this topic to focus. Diagn Microbiol Infect Dis. outstretched or raised Wear gloves and a lab coat or gown when handling blood/body fluids. Sharps Disposal Container. Reasonable informed participation in decisions involving the patient's
health care. Do not use alcohol for prepping the site when drawing a blood alcohol sample. DOC Blood Collection by Venipuncture - Michigan These may include listening to music or a story, watching a video, playing with a toy, having a parent provide distraction with talk or touch, using flash cards, and squeezing a rubber ball. If you stick yourself with a contaminated needle: Remove your gloves and dispose of them properly. The equipment used during the venipuncture test can vary, but the following are most commonly used for routine venipuncture: Phlebotomists may choose to draw blood from several different sites of the body. The 6 Mistakes to Avoid When Building a Business Website (and - Medium Dispose of contaminated materials in appropriate waste receptacles. Proper labeling procedures and completion of laboratory requisitions. Look at the dorsum of the hand as a last resort. The performance of routine vascular access procedures by skilled phlebotomists requires, at a minimum, the use of gloves to prevent contact with blood. Never draw blood through a hematoma. Pediatric Pointers. Center for Phlebotomy Education, Inc. Ernst, Dennis J. and Catherine Ernst. f.style.height="352px"; Previous puncture sites should be avoided. Venipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. 11. Other Factors: Age, gender, and pregnancy have an influence on
laboratory testing. D. All of the above, Needles are sterile until: A test that has been ordered may be cancelled due to problems unrelated to drawing the specimen, and these are the most common causes for cancellations: A test may be cancelled due to a technical problem in the specimen collection process: Identification of the specimen is suspect. Butterflies are incredibly valuable tools for tackling difficult draws, owing to their precision, shorter shaft length, and maneuverability. Dispose of items in appropriate containers. 10. Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site. Collect drops of blood into the collectiondevice by gently massaging the finger. A. just prior to needle insertion Expect that any discussion or consultation involving the patient's case will be conducted discretely and that individuals not directly involved in the case will not be present without patient permission. Some individuals are afraid of needles, while others are frightened at the sight of blood. Approach the patient in a friendly, calm manner. Websites that masquerade as the ones you trust. Apply blood to the printed side of the filter paper. Areas of fingers and heels that are cold, swollen, scarred or covered with a rash, should be avoided. Capillary Specimens may be collected on filter paper and sent to lab for testing for. Let's take a look at the types of websites you and your staff need to be wary of and how to avoid them. A thin soap bubble of index of refraction 1.33 is viewed with light of wavelength 550.0 nm and appears very bright. Identify the patient using two different identifiers, asking open ended questions such as, "What is your name?" 11. Tip: Patients who need regular bloodwork (e.g. There are some slight risks associated with venipuncture which may include excessive bleeding, feeling light-headed, fainting, nerve damage, hematoma (accumulation of blood under the skin), and infection. Larger tube sizes typically provide for collection of samples from 6 to 10 mL. Hard and dense structures may be nerves or tendons. As a countermeasure, phlebotomists anchor the vein with their hand to stabilize it for the draw. Whole blood specimens may not be able to be analyzed if microscopic clots are present. -cotton sponges 2006;52(5-6):217-30. -obvious skin infection (including newly tattooed areas) -extensive scarring -don't use same side as mastectomy -avoid previous hematoma -avoid arm w/ fistula/cannula -edamtous extremity What is the most common site for blood sampling? The recommended location for blood collection on a newborn baby or infant is the heel. Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. It is an employer's responsibility to provide, clean, repair, replace, and/or dispose of personal protective equipment/clothing. 2009;47(2):143-53. This article was co-authored by Matt Garcia. Drawing the patient in a reclined position. Consult a specialist at the patient's own request and expense. Blood should NEVER be poured from one tube to another since the tubes can have different additives or coatings (see illustrations at end). If just a routine coagulation assay is the only test ordered, then a single light blue top tube may be drawn. (See, The chlorhexidine is a concern for the premature babies in NICU as it can, be absorbed through the skin. 8. Blindly maneuvering the needle within the skin is painful to the patient and you run the risk of hitting a nerve, tendon, or artery. This information must match therequisition. -hemorrhage/hematoma. Mix and label all appropriate tubes at the patient bedside. Patient identification is critical for safety. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. Wipe away the first drop of blood with sterile 22 gauze. C. the needle has penetrated all the way through the vein After cleansing, allow the venipuncture site to air dry. Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive. Assess the patient's physical disposition (i.e. If another site is not
available, collect the specimen distal to the hematoma. 5. Phelan MP, Reineks EZ, Berriochoa JP, Schold JD, Hustey FM, Chamberlin J, Kovach A. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Label the collection tubes at the bedside or drawing area. This complication of peripheral I.V. The blood is bright red (arterial) rather than venous. Alcohol not dry in the required amount of time B. Veins less prominent and less filling C. Veins more prominent and easier to puncture D. Blood stop flowing to arteries but not veins A The most common site (s) for the venipuncture procedure is/are the following: Second - coagulation tube (light blue top). Apply the tourniquet below the IV site. Collect drops of blood into the . Located in the antecubital fossa, the median cubital vein is a well anchored, stable vein that rarely rolls during venipuncture. Label all appropriate tubes at the patient bedside. Re-anchor the vein. By holding the needle either by the plastic wings or the hub, phlebotomists can achieve a shallower angle, typically 10-15 degrees. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Lancets are disposed of in an appropriate sharps container as one unit. Punctures to the posterior curvature of the heel cab cause damage to the bones. Am J Clin Pathol. Edematous extremities - tissue fluid accumulation alters test results. Enzymes, proteins, lipids, iron, and calcium are significantly increased with changes in position. Perform the venipuncture, collecting the sample(s) in the appropriate container(s). Factitious biochemical measurements resulting from hematologic conditions. Which of the following actions should the technician take? Perform the venipuncture. Kiechle FL. Serum red top or amber tube with red top. Prepare the equipment, the patient and the puncture site. Last draw - additive tubes in this order: SST (red-gray or gold top). B. sterilized and reused The key elements in labeling are: NOTE: Both of the above MUST match the same on the requisition
form. However, if there is no alternative and an arm with an IV line in place must be used for venipuncture, try to choose a site away from and below the location of the IV. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. https://www.ncbi.nlm.nih.gov/books/NBK138650/pdf/Bookshelf_NBK138650.pdf (Accessed June 13, 2022). PERFORMING A CAPILLARY PUNCTURE - Akron Children's Hospital 1. A key element for successful venipuncture is choosing the best vein. What are some of the reasons to draw blood? World Health Organization. Arteries pulsate, are very elastic, and have a thick wall. What Is Venipuncture? A typical single vial contains about five milliliters, which is about one teaspoon. This preliminary action allows you to safely adjust the needle's position. While the median cubital, cephalic, and basilic veins are the most popular draw sites for blood draws, phlebotomists may resort to other draw sites if their ability to draw is restricted. Coagulation tests (protime and prothrombin time), Tube is designed to contain no contaminating metals, Trace element testing (zinc, copper, lead, mercury) and toxicology, Antiglycolytic agent preserves glucose up to 5 days, HLA tissue typing, paternity testing, DNA studies, Inactivates thrombin and thromboplastin; contains virtually no lead. window.addEventListener('message', function (){ The vein may have collapsed; resecure the tourniquet to increase venous
filling. Penetrate the skin at a 30 to 45 angle at first (even less with a butterfly), then once you get a flash, reduce the angle by bringing the needle assembly down closer to the arm and advance the needle a tiny bit further into the vein. Venipuncture Flashcards | Quizlet In some instances, the legs or feet are required for use, but a physician or doctor should be completing the draw, not a phlebotomist. Observe universal (standard) safety precautions. The venipuncture procedure is complex, requiring both knowledge and skill to perform. Fasting, dietary restrictions,
medications, timing, and medical treatment are all of concern and should be noted on the lab requisition. Nursing Personnel. ROUTINE CAPILLARY PUNCTURE BLOOD COLLECTION GUIDELINES. var f = document.createElement("iframe"); The line must be flushed first. var zf_perma = zf_ifrm_data[0]; f.style.width="100%"; 9. What caution should you observe when using a Vacutainer? How can you tell if you are palpating a vein? The creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and platelet count may increase. When using a syringe inserted into the line, blood must be withdrawn slowly to avoid hemolysis. PDF Venipuncture - Central Zone - Alberta Health Services Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. How to Avoid Dangerous Websites - Lifewire Blood Collection Techniques in Exotic Small Mammals. What are the best veins for venipuncture? As a countermeasure, phlebotomists. After the needle selection, phlebotomists begin to look and feel for a viable vein. Do not add blood to a circle already filled orpartially filled with blood. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Make sure the venipuncture site is dry. C. at a mastectomy site X=[Ar]4s23d5Y=[Ar]4s23d104p1Z=[Ar]4s23d104p6. The basic patient rights endorsed by the JCAHO follow in condensed form are given below. Follow the same procedure as for performing a finger, Order of Draw for a Capillary Puncture: Proper collection of tubes when. Do not bend, break, recap, or resheath needles to avoid accidental needle puncture or splashing of contents. The use of a tourniquet during a venipuncture procedure makes: A. Am J Clin Pathol. Airborne precautions may be considered to provide a level of safety against infectious diseases such as tuberculosis, influenza, and COVID-19. A government issued photo identification card such as a driver's license can aid in resolving identification issues. 1. previous experience with vomiting or fainting The first step to choosing the right vein is to select the appropriate needle gauge. What are the helpful hints for finding veins? Venipuncture Quiz Flashcards | Quizlet Focus on what you do best, and find someone who can help you communicate that with your target market. Some images used in this set are licensed under the Creative Commons through Flickr.com.Click to see the original works with their full license. Capillary Specimens may be used immediately for point-of-care testing. -keep extremity below heart level for a few minutes. Hematoma - may cause erroneous test results. You will be redirected once the validation is complete. Avoid previous hematoma (draw distal of hematoma) Position the patient with the arm extended to form a straight-line form shoulder to wrist. Diurnal variations associated with some blood components are: Hemoconcentration: An increased concentration of larger molecules and formed elements in the blood may be due to several factors: Prolonged tourniquet application (no more than 1 minute). What are the red top containers used for? D. discarded in the trash, True or False? Therefore, your anchor should be gentle but firm to prevent the vein from moving away from you. A. given to the patient Try rotating the arm to better expose the cephalic or basilic vein. Capillary puncture should not be used. and "What is your date of birth?". Most commonly, venipuncture will be performed on the Antecubital Fossa, or the inside of the elbow. This image may not be used by other entities without the express written consent of wikiHow, Inc. \n<\/p>
\n<\/p><\/div>"}, 7 Easy Ways to Figure Out Your Blood Type (With or Without a Test). EDTA and sodium citrate tubes should still be filled to the marked fill line to ensure a correct blood-to-additive ratio. Recognize complications associated with the phlebotomy procedure. Cap, rotate and invert the microtainer to mix the blood collected. 1. For operation at steady state, determine for the motor, each in kW\mathrm{kW}kW How To Draw Blood | Phlebotomy Coach Using a sterile lancet, make a skin puncture just off the center of the finger pad. Expect reasonable safety congruent with the hospital practices and
environment. 5 Common Capillary Puncture Blood Collection Sites - Neoteryx
